Individual provider · NPI-1

Annalisa G Averill, RD

Dietitian, Registered · Glendale, AZ

NPI number1174000970
StatusActive
Last updated in NPPESJul 24, 2018

Details

NPI
1174000970
Entity type
Individual (NPI-1)
Name
Annalisa G Averill
Credential
RD
Sex
Female
Sole proprietor
No
Enumeration date
Jul 24, 2018
Last updated
Jul 24, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
133V00000X Dietitian, Registered86068951AZYes

Practice location

18001 N 79th Ave Ste A12
Glendale, AZ 85308-8398

Phone 623-399-6825 · Fax 623-505-3474

Mailing address

18001 N 79th Ave Ste A12
Glendale, AZ 85308-8398

Phone 623-399-6825 · Fax 623-505-3474

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